Fabio Costa, Giuseppe Pascarella, Chiara Piliego, Antongiulio Valenzano, Enrico Di Sabatino, Filippo Riccone, Federica Bruno, Eugenio Agro' F
Unit of Anesthesia and Intensive Care, Policlinico Universitario Campus Biomedico, Via Alvaro del Portillo 200, Rome, Italy.
Saudi J Anaesth. 2019 Jul-Sep;13(3):222-226. doi: 10.4103/sja.SJA_109_19.
Sufentanil sublingual tablet system (SSTS) (Zalviso) is a sublingual system for patient controlled analgesia, demonstrated to be an effective strategy for pain control after major abdominal and orthopedic surgery. We present a prospective observational study on the use of SSTS for the management of postoperative pain after thoracic surgery. The aim of this study was to assess the efficacy of Zalviso in reducing pain scores and increasing respiratory ability during postoperative period.
There were about 40 patients underwent video assisted thoracoscopy were included in the study. All the enrolled patients signed the informed consent were educated to the use of the device. Pain numeric rating scale values (NRS) were recorded at awakening from anesthesia (T0) and during the next hours, both at rest and with cough. We evaluate the time to obtain a mean NRS value ≤3 and difference in pain scores between first and subsequent measurements as the primary outcomes. The ability to use incentive spirometer and eventual drug adverse effect were evaluated as secondary outcomes.
All patients in recovery room experienced moderate to severe pain. Pain score at rest and coughing decreased to a mean NRS value ≤3 (mild pain) respectively after 2 and 6 hours and the pain score difference continued to increase significantly after repeated measurements. 67.5% of patients resumed the original spirometric ability in pod 1; 9.5% in pod 2; 12% in pod 3. Only three patients out of forty (7,5%) experienced nausea; one patient (2,5%) had a vomiting episode.
Our study showed SSTS as an effective option for postoperative pain management in thoracic surgery, improving pain scores and respiratory ability.
舒芬太尼舌下片系统（SSTS）（Zalviso）是一种用于患者自控镇痛的舌下给药系统，已被证明是腹部和骨科大手术后疼痛控制的有效策略。我们开展了一项关于使用SSTS管理胸外科术后疼痛的前瞻性观察性研究。本研究的目的是评估Zalviso在降低术后疼痛评分和提高呼吸能力方面的疗效。
本研究纳入了约40例行电视辅助胸腔镜手术的患者。所有纳入研究的患者均签署了知情同意书，并接受了该设备使用的培训。在麻醉苏醒时（T0）以及随后的数小时内，记录静息和咳嗽时的疼痛数字评分量表值（NRS）。我们将获得平均NRS值≤3的时间以及首次与后续测量之间的疼痛评分差异作为主要结局进行评估。将使用激励肺活量计的能力和最终的药物不良反应作为次要结局进行评估。
恢复室中的所有患者均经历了中度至重度疼痛。静息和咳嗽时的疼痛评分分别在2小时和6小时后降至平均NRS值≤3（轻度疼痛），且重复测量后疼痛评分差异继续显著增加。67.5%的患者在术后第1天恢复了原有的肺活量计使用能力；术后第2天为9.5%；术后第3天为12%。40名患者中只有3名（7.5%）出现恶心；1名患者（2.5%）发生呕吐。
我们的研究表明，SSTS是胸外科术后疼痛管理的有效选择，可改善疼痛评分和呼吸能力。
